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HomeMy WebLinkAbout13215RESOLUTION NO. 13215 A RESOLUTION AWARDING A PROFESSIONAL SERVICES AGREEMENT IN THE AMOUNT OF $38,220 TO RAFTELIS FINANCIAL CONSULTANTS, INC. FOR THE 2015 BIENNIAL WASTEWATER RATE REVIEW WHEREAS, Section 16-7-9 of the Pueblo Municipal Code requires biennial review of wastewater rates and fees; and WHEREAS, Raftelis Financial Consultants, Inc. was selected as the Rate Consultant of Record for wastewater utility fees; NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF PUEBLO, that: SECTION 1. The Agreement for Professional Services by and between Pueblo, a Municipal Corporation, and Raftelis Financial Consultants, Inc., a true copy of which is attached hereto and incorporated herein by reference (the “Agreement”) having been approved as to form by the City Attorney, is hereby approved. SECTION 2. Work performed under this Agreement includes review and analysis of wastewater rates and charges, including user charges, excessive strength surcharges, industrial pretreatment charges, and system development fee use policies, and related ancillary services with respect to the 2015 biennial review. SECTION 3. Funds for work performed under this Agreement in the amount of $38,220.00 shall be from the Sewer User Fund. SECTION 4. The President of City Council is hereby authorized to execute the Agreement in the name and on behalf of the City and the City Clerk is directed to affix the seal of the City thereto and attest same. SECTION 5. The officers and staff of the City are directed and authorized to perform any and all acts consistent with the intent of this Resolution and the attached agreement to effectuate the transactions described therein. SECTION 6. This Resolution shall become effective immediately upon passage and approval. INTRODUCED: April 27, 2015 BY: Dennis Flores City Clerk’s Office Item # M-4 Background Paper for Proposed Resolution COUNCIL MEETING DATE: April 27, 2015 TO: President Stephen G. Nawrocki and Members of City Council CC: Sam Azad, City Manager VIA: Gina Dutcher, City Clerk From: Gene Michael, Wastewater Director SUBJECT: A RESOLUTION AWARDING A PROFESSIONAL SERVICES AGREEMENT IN THE AMOUNT OF $38,220 TO RAFTELIS FINANCIAL CONSULTANTS, INC. FOR THE 2015 BIENNIAL WASTEWATER RATE REVIEW SUMMARY: Attached is a Resolution accepting an agreement between the City of Pueblo and Raftelis Financial Consultants, Inc for professional services associated with providing sanitary sewer rate consulting. PREVIOUS COUNCIL ACTION : April 27, 2015 Resolution accepting contract between the City of Pueblo and Raftelis Financial Consultants, Inc., and naming Raftelis Financial Consultants, Inc. as the Rate Consultant of Record for Wastewater. BACKGROUND : Section 16-7-9 of the Pueblo Municipal Code requires biennial review of sanitary sewer rates and fees. As an enterprise of the City of Pueblo, the Wastewater Department is obligated to collect sufficient funds through its rates and fees to pay for its operations. Operating and maintaining the infrastructure of these facilities entails increasing costs. Raftelis Financial Consultants, Inc. was selected as the Rate Consultant of Record for wastewater utility fees. The attached professional services agreement between the City and Raftelis Financial Consultants, Inc. provides for the required biennial rate review in 2015. FINANCIAL IMPLICATIONS : Funds for the professional services related to the rate review are available from the Sewer User Fund. BOARD/COMMISSION RECOMMENDATION : Not applicable STAKEHOLDER PROCESS : Not applicable ALTERNATIVES : Not applicable. The Municipal Code requires that sanitary sewer rates be reviewed no less often than every two years. Raftelis Financial Consultants, Inc. was selected as the City’s Wastewater Rate Consultant of Record through a competitive bid process. RECOMMENDATION : Approval of the Resolution. Attachments : A copy of the contract with Raftelis Financial Consultants, Inc.. AGREEMENT FOR PROFESSIONAL SERVICES THIS AGREEMENT is made and entered this 27th day of April, 2015, by and between Pueblo, a Municipal Corporation("Client")and Raftelis Financial Consultants, Inc. (hereinafter referred to as"Consultant") lot-Consultant to render professional consulting services for Client with respect to review and analysis of wastewater rates and charges, including user charges, excessive strength surcharges, industrial pretreatment charges, and system development fee use policies, and related ancillary services, hereinafter referred to as the "Project." In consideration of the mutual covenants hereinafter set forth, the parties agree as follows: SECTION L GENERAL AND SCOPE OF SERVICES. (a) Consultant shall satisfactorily perform the professional planning and consulting services for the Project described in more detail in Exhibit I attached hereto and incorporated herein by reference (the "Basic Services"). Such services shall include all usual and customary professional consulting services including any required drafting or design services incident to its work on the Project. In the event this Agreement follows the selection of Consultant by Client pursuant to a Request for Proposals or RFP, all of the requirements of that Request for Proposal or REP are incorporated herein by reference, unless any requirement is expressly excluded in Exhibit 1. (b) To the extent Consultant performs any of the Project work through subcontractors or subconsultants, Consultant shall be and remain as fully responsible for the fall performance and quality of services performed by such subcontractors or subconsultants as it is for services performed directly by Consultant or Consultant's employees. (c) To the extent Consultant requires access to private property to perform its services hereunder, Consultant shall be required to make arrangements to obtain such access. However, in the event Client has already secured access for Consultant to any such property through a right of entry agreement, access agreement, letter of consent or other instrument, Consultant shall fully comply with and be subject to the terms and conditions set forth therein. A copy of any such instrument will be provided to Consultant upon request. SECTION 2. CONSULTANT'S RESPONSIBILITIES. (a) Consultant shall he responsible for the professional quality, technical accuracy and timely completion of Consultant's work, including that performed by Consultant's subconsultants and subcontractors, and including drawings, reports and other services, irrespective of Client's approval of or acquiescence in same. (b) Consultant shall he responsible, in accordance with applicable law, to Client for all loss or damage to Client caused by Consultant's negligent act or omission; except that Consultant hereby irrevocably waives and excuses Client and Client's attorneys from compliance with any requirement to obtain a certificate of review as a condition precedent to commencement of an action, including any such requirements set forth in Section 13-20-602, C.R.S. or similar statute, whether now existing or hereafter enacted. (c) Consultant shall be completely responsible for the safety of Consultant's employees in the execution of work under this Agreement and shall provide all necessary safety and protective equipment for said employees. (d) Consultant acknowledges that time is of the essence with respect to the completion of its services under this Agreement. Consultant represents that Exhibit 2 attached hereto is the schedule by which Consultant proposes to accomplish its work, with time periods for which it will commence and complete each major work item. Except to the extent the parties agree to time extensions for delays beyond the control of Consultant, Consultant shall adhere to this schedule and perform its work in a timely manner so as not to delay Client's timetable for achievement of interim tasks and final completion of Project work. Consultant further acknowledges that its schedule has accounted for all reasonably anticipated delays, including those inherent in the availability of tools, supplies, labor and utilities required for the work, the availability of information which must be obtained from any third parties, and all conditions to access to public and private facilities. (e) Before undertaking any work or incurring any expense which Consultant considers beyond or in addition to the Scope of Work described in Schedule I or otherwise contemplated by the terms of this Agreement, Consultant shall advise - 1 - Client in writing that (i) Consultant considers the work beyond the scope of this Agreement, (ii) the reasons that Consultant believes the out of scope or additional work should be performed, and (iii) a reasonable estimate of the cost of such work. Consultant shall not proceed with any out of scope or additional work until authorized in writing by Client. The compensation for such authorized work shall be negotiated, but in the event the parties fail to negotiate or are unable to agree as to compensation, then Consultant shall be compensated for its direct costs and professional time at the rates set forth in Exhibit 3 attached hereto. SECTION 3. FEES FOR SERVICES; PAYMENT. (a) Client will pay to Consultant as full compensation for all services required to be performed by Consultant under this Agreement, except for services for additional work or work beyond the scope of this Agreement, the maximum sum ()ILLS. $38,220, computed as set forth in Exhibit 3. (b) Consultant shall submit periodic, but not more frequently than monthly, applications for payment, aggregating to riot more than the maximum amount set forth above, for actual professional services rendered and for reimbursable expenses incurred. Applications for payment shall be submitted based upon the hourly rates and expense reimbursement provisions set forth in Exhibit 3 attached hereto, and shall contain appropriate documentation that such services have been performed and such expenses incurred. Thereafter, Client shall pay Consultant for the amount of the application within 45 days of the date such application is received. (c) No separate or additional payment shall be made for profit, overhead, local telephone expenses, lodging, routine photocopying, computer time, secretarial or clerical time or similar expenses unless otherwise provided and listed in Exhibit 3. (d) No compensation shall be paid to Consultant for services required and expenditures incurred in correcting Consultant's mistakes or negligence. (e) Compensation for authorized work beyond the scope of this Agreement shall be governed by the provisions of-Section 2(e). (f) In the event services under this Agreement are phased and to be performed in more than one fiscal year or are subject to annual appropriation, Consultant acknowledges that funds only in the amount of initial appropriation are available and it shall confirm availability of funds before proceeding with work exceeding initial and subsequent annual appropriations. SECTION 4. CLIENT'S RESPONSIBILITIES. (a) Client agrees to advise Consultant regarding Client's Project requirements and to provide all relevant information,surveys, data and previous reports accessible to Client which Consultant may reasonably require. (b) Client shall designate a Project Representative to whom all communications from Consultant shall be directed and who shall have limited administrative authority on behalf of Client to receive and transmit information and make decisions with respect to the Project. Said representative shall not, however, have authority to bind Client as to matters of governmental policy or fiscal policy, nor to contract for additions or obligations exceeding a value which is the lesser of$5000 or 5%of the maximum contract price. (c) Client shall examine all documents presented by Consultant, and render decisions pertaining thereto within a reasonable time. The Client's approval of any drawings, specifications, reports, documents or other materials or product furnished hereunder shall not in any way relieve Consultant of responsibility for the professional adequacy of its work. (d) Client shall perform its obligations and render decisions within a reasonable time under the circumstances presented. Based upon the nature of Client and its requirements, a period of 14 days shall be presumed reasonable for any decision not involving policy decision or significant financial impact, when all information reasonably necessary for Client to responsibly render a decision has been furnished, A period of 46 days shall be presumed reasonable for Client to act with respect to any matter involving policy or significant financial impact. The above periods of presumed reasonableness shall be extended where information reasonably required is not within the custody or control of Client but must be procured from others. _ 2 - SECTION 5. TERMINATION, (a) Client reserves the right to terminate this Agreement and Consultant's performance hereunder, at any time upon written notice, either for cause or for convenience. Upon such termination, Consultant and its subcontractors shall cease all work and stop incurring expenses, and shall promptly deliver to Client all data, drawings, specifications, reports, plans, calculations, summaries and all other information, documents, work product and materials as Consultant may have accumulated in performing this Agreement, together with all finished work and work in progress. (b) Upon termination of this Agreement for events or reasons not the fault of Consultant, Consultant shall be paid at the rates specified in Exhibit 3 for all services rendered and reasonable costs incurred to date of termination; together with any reasonable costs incurred within 10 days of termination provided such latter costs could not be avoided or were incurred in mitigating loss or expenses to Consultant or Client. In no event shall payment to Consultant upon termination exceed the maximum compensation provided for complete performance in Section 3(a). (c) In the event termination of this Agreement or Consultant's services is for breach of this Agreement by Consultant, or for other fault of Consultant including but not limited to any failure to timely proceed with work, or to pay its employees and consultants, or to perform work according to the highest professional standards, or to perform work in a manner deemed satisfactory by Client's Project Representative, then in that event, Consultant's entire right to compensation shall be limited to the lesser of(a) the reasonable value of completed work to Client or(b) payment at the rates specified in Exhibit 3 for services satisfactorily performed and reimbursable expenses reasonably incurred,prior to date of termination. (d) Consultant's professional responsibility for its completed work and services shall survive any termination. SECTION 6. SITE ACCESS. In the event the Project will require access to property not under the control of Client, Consultant and Consultant's employees and consultants shall obtain all additional necessary approval and clearances required for access to such property. Client shall assist Consultant in obtaining access to such property at reasonable times but makes no warranty or representation whatsoever regarding access to such property. Notwithstanding the foregoing, Consultant understands and agrees that entry to some property by Consultant may be subject to compliance by Consultant with the terms and conditions of an access agreement in accordance with section 1(c)of this Agreement, SECTIO.N__7_USE OF.[X)CUMENTS. (a) Plans, drawings, designs, specifications, reports and all other documents prepared or provided by Consultant hereunder shall become the sole property of Client, subject to applicable federal grant requirements, and Client shall be vested with all rights therein of whatever kind and however created, whether by common law, statute or equity. Client shall have access at all reasonable times to inspect and make copies of all notes, designs, drawings, specifications, and all other technical data or other documents pertaining to the work to be performed under this Agreement. In no event shall Consultant publish work product developed pursuant to this Agreement except (i) with advance written consent of Client, which consent may be granted or withheld in Client's sole and absolute discretion and(ii) in full compliance with the requirements of this Agreement and applicable federal regulations. _ 3 _ SECTION 8. INSURANCE AND INDEMNITY. (a) Consultant agrees that it shall procure and will maintain during the term of this Agreement, such insurance as will protect it from claims under workers' compensation acts, claims for damages because of personal injury including bodily injury, sickness or disease or death of any of its employees or of any person other than its employees, and from claims or damages because of injury to or destruction of property including loss of use resulting therefrom; and such insurance will provide for coverage in such amounts as set forth in subparagraph(b). (b) The minimum insurance coverage which Consultant shall obtain and keep in force is as follows: (i) Workers' Compensation Insurance complying with statutory requirements in Colorado and in any other state or states where the work is performed. The Workers' Compensation Insurance policy shall contain an endorsement waiving subrogation against the Client. (ii) Commercial General Liability Insurance. The Consultant shall secure and maintain during the period of this agreement/contract and for such additional time as work on the project is being performed, Commercial General Liability Insurance issued to and covering the liability of the contractor with respect to all work performed by him and all his subcontractors under the agreement/ contract, to be written on a comprehensive policy form. This insurance shall be written in amounts not less than $1,000,000 for each occurrence and aggregate for personal injury including death and bodily injury and$1,000,000 for each occurrence and aggregate for property damage. This policy of insurance shall name the City of Pueblo, its agents, officers and employees as additional insureds. This policy shall have all necessary endorsements to provide coverage without exclusion for explosion and collapse hazards, underground property damage hazard, blanket contractual coverage, as well as Owner's and Contractor's Protective Liability (OCP) coverage. The policy shall also provide coverage for contractual liability assumed by Contractor under the provisions of the Agreement/Contract, and"Completed Operations and Projects Liability"coverage. (iii) Professional Liability Insurance with coverage of not less than $1,000,000, and with a deductible of not more than $ 5,000. (iv) Comprehensive Automobile Liability Insurance. The Consultant shall procure and maintain during the period of the agreement/contract and for such additional time as work on the project is being performed, Comprehensive Automobile Liability Insurance. This insurance shall be written with limits of liability for and injury to one person in any single occurrence of not less than $350,000 and for any injury to two or more persons in any single occurrence of not less than $1.000,000. "Phis insurance shall include uninsured/underinsured motorist coverage and shall protect the Consultant from any and all claims arising from the use both on and off the site of the project of automobiles, trucks, tractors, backhoes and similar equipment whether owned, leased,hired or used by Consultant. (c) Consultant agrees to hold harmless, defend and indemnify Client from and against any liability to third parties, arising out of negligent acts or omissions of Consultant, its employees, subcontractors and consultants. SECTION 9. SUBCONTRACTS_ (a) Client acknowledges that Consultant is the prime contractor and the only party with whom Client has a contractual relationship under this Agreement. To the extent Consultant performs any Project activities through subconsultants or subcontractors, Consultant shall contractually bind each of its subconsultants and subcontractors by subcontract agreement to all of the terms of this Agreement which are For the benefit of Client, and Client shall be a third party beneficiary of those subcontract provisions. (b) Consultant shall indemnify and defend Client from all claims and demands for payment for services provided by subcontractors of Consultant. (c) Consultant acknowledges that, due to the nature of the services to be provided under this Agreement, the Client has a substantial interest in the personnel and consultants to whom Consultant assigns principal responsibility for services performed under this Agreement. Consequently. Consultant represents that it has selected and intends to employ or assign the key personnel and consultants identified in its proposal submitted to Client prior to execution of this Agreement to induce Client to enter this Agreement. Consultant shall not change such consultants or key personnel except after giving notice of a proposed change to Client and receiving Client's consent thereto. Consultant shall not assign or reassign Project work to - 4 - any person to whom Client has reasonable objection. SECTION 10. (RESERVED) SECTION I I. MISCELLANEOUS. (a) Notices. Any and all notices or other communications required or permitted by this Agreement or by law to be served on or given to either Consultant or Client by the other party shall be in writing and shall he deemed duly served and given when personally delivered to the party to whom it is directed, or in lieu of such personal service, when deposited in the United States mail, first-class postage prepaid, addressed to the Client, Attention: Cult Michael, Wastewater Director, 1300 ti_Oueens Ave. Pueblo, Colorado, 81001 or to Consultant at: Diane Adams, Chief Financial Officer. Raftelis Financial Consultants, Inc.. 1031 S Caldwell St.,Suite 100,Charlotte NC 28203 Either party may change his address for the purpose of this paragraph by giving written notice of such change to the other party in the manner provided in this paragraph. (b) Entire Agreement. '['his instrument contains the entire agreement between Consultant and Client respecting the Project, and any other written or oral agreement or representation respecting the Project or the duties of either Client or Consultant in relation thereto not expressly set forth in this instrument and its attachments is null and void. In the case of any conflict between the terms of this Agreement for Professional Services and terms of Exhibit 1 or any other attachment hereto, the terms of this Agreement shall govern. (c) Successors and Assigns. This Agreement shall be binding on the parties hereto and on their successors and assigns; provided, however, neither this Agreement, nor any part thereof, nor any moneys due or to become due hereunder to Consultant may be assigned by it without the written consent of Client, which consent may he withheld in Client's sole and absolute discretion. Any assignment or attempted assignment in violation of this subsection shall be void, (d) Amendments. No amendment to this Agreement shall be made nor be enforceable unless made by written amendment signed by an authorized representative of Consultant and by Client in accordance with the requirements of Section 4(b)of this Agreement or upon authorization of Client's governing board. (e) Choice of Law. This Agreement shall be governed and interpreted in accordance with the laws of the State of Colorado, Any unresolved dispute arising from or concerning any breach of this Agreement shalt'be decided in a state court of competent jurisdiction located in Pueblo, Colorado. (t) Equal Employment Opportunity. In connection with the performance of this Agreement, neither Consultant nor its consultants shall discriminate against any employee or applicant for employment because of race, color, religion, sex, national origin, disability or age. Consultant shall endeavor to insure that applicants are employed, and that employees are treated during employment without regard to their race,color, religion, sex,national origin, disability or age. (g) Severability. If any provision of this Agreement, except for Section 2, is determined to be directly contrary to and prohibited by law or the requirements of any federal grant or other Project funding source, then such provision shall be deemed void and the remainder of the Agreement enforced. However, it is the intent of the parties that Section 2 of this Agreement not be severable, and that if any provision of said section be determined to he contrary to law or the terms of any federal grant, then this entire Agreement shall be void. SECTION 12. STAT IMPOSED MANDATES PRn1,1IIHITING ILLEGAL,ALIENS FROM PERFORMING WORK (a) At or prior to the time for execution of this Agreement(which may be referred to in this section as this "Contract"), Consultant(which may be referred to in this section as"Contractor")shall submit to the Purchasing Agent of City its certification that it does not knowingly employ or contract with an illegal alien who will perform work under this Contract and that the Contractor will participate in either the"EVctify Program"created in Public Law 208, 104`x`Congress, as amended and expanded in Public Law 1.56, 1081 Congress,as amended,that is administered by the United States Department of Homeland Security or the"Department Program" established pursuant to :;8-17.5-102(5)(c)C.R.S. that is administered by the Colorado Department of Labor and Employment in order to confirm the employment eligibility of all employees who are newly hired for employment to perform work under tins Contract. (b) Contractor shall not: • (I) Knowingly employ or contract with an illegal alien to perform work under this contract; (II) Enter into a contract with a subconsultant that fails to certify to Contractor that the subconsultant shall not knowingly employ or contract with an illegal alien to perform work under this Contract, (c) The following state-imposed requirements apply to this contract: (I) The Contractor shall have confirmed the employment eligibility of all employees who are newly hired for employment to perform work under this Contract through participation in either the E-Verify Program or Department Program. (II) The Contractor is prohibited from using either the E-Verify Program or Department Program procedures to undertake pre-employment screening of.job applicants while this Contract is being performed. (III) If the Contractor obtains actual knowledge that a subcontractor or subconsultant performing work under this Contract knowingly employs or contracts with an illegal alien, the Contractor shall be required to: A. Notify the subconsultant and the Client's Purchasing Agent within three (3) days that the Contractor has actual knowledge that the subcontractor/subconsultant is employing or contracting with an illegal alien;and B. Terminate the subcontract with the subcontractor/subconsultant if within three (3) days of receiving the notice required pursuant to subparagraph (c)(III)A. above the subcontractorisubconsultant does not stop employing or contracting with the illegal alien; except that the Contractor shall not terminate the contract with the subcontractor/subconsultant if, during such three (3) days, the subcontractor/subconsultant provides information to establish that the subcontractorisubconsultant has not knowingly employed or contracted with an illegal alien. (IV) The Contractor is required to comply with any reasonable request by the Colorado Department of Labor and Employment (hereinafter referred to as "CDLE") made in the course of an investigation that CDLE is undertaking pursuant to its authority under §8-17.5-102(5),C.R.S. (d) Violation of this Section 12 by the Contractor shall constitute a breach of contract and grounds for termination. In the event of such termination, the Contractor shall be liable for Client's actual and consequential damages. (e) As used in this Section 12, the terms "subcontractor" and "subconsultant" shall mean any subconsultant or subcontractor of Consultant rendering services within the scope of this Agreement. SECTION 13. Reserved. SECTION 14. PERS.LIABILITY Consultant shall reimburse the City for the tail amount of any employer contribution required to be paid by the City of Pueblo to the Public Employees' Retirement Association ("PER.A") for salary or other compensation paid to a PERA retiree performing contracted services for the City under this Agreement. The Consultant shall fill out the questionnaire attached as Exhibit A and submit the completed form to Client as part of the signed Agreement. IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement as of the day and year first above written, CITY - - ' TTI IOTPCT2r ION aillp Presi e City Council - 6 - ATTEST: APPROVED AS TO FORM \-,c City Attorney City c. I< ... "1"Jij'''' - 1.<70 V.4a-e_ ., ___ CO' J ANT: 0 al,-,,, , , co By: WI Ch4100 0. (5)4540' ing\ Title: Nme; &)k-Q jit1/4/4Uk 6 iii: BALANCE OF APPROPRIATION EXISTS FOR THIS CONTRACT AND FUNDS ARE AVAILABLE. eettAZ VW/Lit Director of Finance - 7 - COLORADO PUBLIC EMPLOYEES RETIREMENT ASSOCIATION SUPPLEMENTAL QUESTIONNAIRE TO BE ANSWERED BY ANY BUSINESS PERFORMING SERVICES FOR THE CITY OF PUEBLO Pursuant to section 24-51-1101(2), C.R.S., salary or other compensation from the employment, engagement, retention or other use of a person receiving retirement benefits (Retiree) through the Colorado Public Employees Retirement Association (PERA) in an individual capacity or of any entity owned or operated by a PERA Retiree or an affiliated party by the City of Pueblo to perform any service as an employee, contract employee, consultant, independent contractor, or through other arrangements, is subject to employer contributions to PERA by the City of Pueblo. Therefore, as a condition of contracting for services with the City of Pueblo, this document must be completed,signed and returned to the City of Pueblo: (a) Are you, or do you employ or engage in any capacyty, including an independent contractor, a PERA Retiree who will perform any services for the City of Pueblo? Yes , Not (Mist sign below wheiher you answer "ryes"or "no') (b) If you answered "yes" to (a) above, please answer the following question: Are you 1) an individual, 2) sole proprietor or partnership, or 3) a business or company owned or operated by a PERA Retiree or an affiliated party? Yes No If you answered "yes" please state which of the above listed entities (1, 2, or 3) best describes your business: (c) If you answered "yes" to both (a) and (b), please provide the name, address and social security number of each such PERA Retiree. Name Name, Address esss Address Social Security Number Social Security Number (If more than two,please attach a supplemental list) If you answered "yes" to both (a) and (b), you agree to reimburse the City of Pueblo for any employer contribution required to be paid by the City of Pueblo to PERA for salary or other compensation paid to you as a PERA Retiree or paid to any employee or independent contractor of yours who is a PERA Retiree performing services for the City of Pueblo. You further authorize the City of Pueblo to deduct and withhold all such contributions from any moneys due or payable to you by the City of Pueblo under any current or future contract or other arrangement for services between you and the City of Pueblo. Failure to accurately complete, sign and return this document to the City of Pueblo may result in your being denied the privilege of doing business with the City of Pueblo. Signed ! 20 45 • By: ._ Ukr,‘ G") 81b - -CNWO - . v- A"✓/ Title, 4x'poL,LiheNtik Ul 6100 /11110. For purposes of responding to question (b) above, an "affiliated party" includes (1) any person who is the named beneficiary or cobeneficiary on the PERA account of the PERA Retiree;(2) any person who is a relative of the PERA Retiree by blood or adoption to and including parents, siblings, half-siblings, children, and grandchildren; (3) any person who is a relative of'the PERA Retiree by marriage to and including spouse,spouse's parents, stepparents, stepchildren, stepsiblings, and spouse's siblings;and(4)any person or entity with whom the PERA Retiree has an agreement to share or otherwise prent from the performance of services for the City of Pueblo by the PERA Retiree other than the PERA Retiree's regular salary or compensation. - 8 -